Disability, Hospital Care, and Cost: Utilization of Emergency and Inpatient Care by a Cohort of Children with Intellectual and Developmental Disabilities

Details

• Alternative Title:
  J Pediatr
• Personal Author:
  Lindgren, Scott ; Lauer, Emily ; Momany, Elizabeth ; Cope, Tara ; Royer, Julie ; Cogan, Lindsay ; McDermott, Suzanne ; Armour, Brian S.
• Description:
  Objective
  
  To use medical claims data to determine patterns of healthcare utilization in children with intellectual and developmental disabilities, including frequency of service utilization, conditions that require hospital care, and costs.
  
  Study design
  
  Medicaid administrative claims from 4 states (Iowa, Massachusetts, New York, and South Carolina) from years 2008-2013 were analyzed, including 108 789 children (75 417 male; 33 372 female) under age 18 years with intellectual and developmental disabilities. Diagnoses included cerebral palsy, autism, fetal alcohol syndrome, Down syndrome/trisomy/autosomal deletions, other genetic conditions, and intellectual disability. Utilization of emergency department (ED) and inpatient hospital services were analyzed for 2012.
  
  Results
  
  Children with intellectual and developmental disabilities used both inpatient and ED care at 1.8 times that of the general population. Epilepsy/convulsions was the most frequent reason for hospitalization at 20 times the relative risk of the general population. Other frequent diagnoses requiring hospitalization were mood disorders, pneumonia, paralysis, and asthma. Annual per capita expenses for hospitalization and ED care were 100% higher for children with intellectual and developmental disabilities, compared with the general population ($153 348 562 and $76 654 361, respectively).
  
  Conclusions
  
  Children with intellectual and developmental disabilities utilize significantly more ED and inpatient care than other children, which results in higher annual costs. Recognizing chronic conditions that increase risk for hospital care can provide guidance for developing outpatient care strategies that anticipate common clinical problems in intellectual and developmental disabilities and ensure responsive management before hospital care is needed.
  
  
• Subjects:
  Adolescent Child Child, Preschool Developmental Disabilities Emergency Service, Hospital Facilities And Services Utilization Female Health Care Costs Hospitalization Humans Infant Intellectual Disability Iowa Male Massachusetts New York South Carolina

  More +
• Source:
  J Pediatr. 229:259-266
• Pubmed ID:
  32890584
• Pubmed Central ID:
  PMC7885996
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01DD001007/ACL/ACL HHSUnited States/
• Volume:
  229
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:173309fc726b121cf019439a39e9c1cb352f61371163d1ebf7ede08befeed347
• Download URL:
  https://stacks.cdc.gov/view/cdc/103518/cdc_103518_DS1.pdf
• File Type:
  [PDF - 199.61 KB ]